Abstract:
ObjectiveTo compare the effects between catheter-directed thrombolysis combined with iliac vein stent implantation and catheter-directed thrombolysis in the treatment of acute iliofemoral vein thrombosis.
MethodsThe clinical data of 86 patients with acute iliofemoral vein thrombosis complicated with severeiliac vein stenosis treated with anticoagulation combined with catheter-directed thrombolysis were retrospectively analyzed.Thirty-two patients treated with catheter-directed thrombolysis combined with balloon dilatation and stent implantation to open iliofemoral vein and 54 patients treated with catheter-directed thrombolysis alone were divided into the observation group and control group, respectively.The thrombosis elimination rate, limb swelling relief and perioperative complications were counted.The occurrence of post-thrombotic syndrome(PTS) and severity of venous clinical symptoms in two groups after 3, 6, 12 and 24 months of operation were evaluated using Villalta scale and Vcss scale.
ResultsThe elimination rate of grade Ⅲ thrombus in two groups by catheter-directed thrombolysis was 82.6%.There was no statistical significance in thrombolytic time, urokinase dosage, length of stay, perioperative complications, incidence of PTS and thrombus recurrence rate between two groups(P>0.05).The circumference difference of up 15 cm of knee in observation group was smaller than that in control group(P < 0.05).During the following-up 3, 6 12 and 24 months, the Villalta signs and symptoms evaluation and Vcss score in observation group were smaller than those in control goup(P < 0.05 to P < 0.01).
ConclusionsThe thrombus clearance rate of catheter-directed thrombolysis in the treatment of acute iliofemoral venous thrombosis is high, which combined with opening iliofemoral vein with balloon dilatation and stent implantation can improve the symptoms and clinical therapeutic effect.